The fifth annual assessment of the nation's day-to-day preparedness for managing community health emergencies found Tennessee held steady over the last year. The Robert Wood Johnson Foundation (RWJF) released the results of the 2018 National Health Security Preparedness Index, which found Tennessee scored 6.9 on a 10-point scale for preparedness, compared to 7.1 for the United States as a whole. The nation's overall preparedness improved slightly over the last year, though deep regional inequities are becoming more pronounced.

"Threats to America's health security are on the rise, but so is our nation's preparedness to deal with these emergencies," said Alonzo Plough, PhD, MPH, vice president of research-evaluation-learning and chief science officer at RWJF. "The Index shows how prepared public and private stakeholders are to tackle health security challenges and sheds light on areas for improvement."

The Index analyzes 140 measures--such as the percentage of bridges that are in good or fair condition, the number of pediatricians, and flu vaccination rates--to calculate a composite score that provides the most comprehensive picture of health security available. The scores indicate the ability to protect the health security of Americans from incidents like newly emerging infectious diseases, growing antibiotic resistance, terrorism and extreme weather conditions.

Based on a model informed by experts in public health, emergency management, academia, health care, and other sectors, researchers collect, aggregate, and measure health security data from more than 50 sources. The final measures fall into six categories, each of which is assessed independently, and cover topics such as:

Topic

2018 National Average

Tennessee 2018 Score

Tennessee 2013 Score

Health security surveillance: The ability to monitor and detect health threats, and to identify where hazards start and spread so that they can be contained rapidly.

8.1

8.4

6.4

Community planning and engagement: The ability to develop and maintain supportive relationships among government agencies, community organizations, and individual households.

6.0

5.7

5.4

Information and incident management: The ability to deploy people, supplies, money, and information to the locations where they are most effective in protecting health.

8.8

8.8

8.1

Healthcare delivery: The ability to ensure access to high-quality medical services across the continuum of care during and after disasters and emergencies.

5.2

4.6

4.7

Countermeasure management: The ability to store and deploy medical and pharmaceutical products that prevent and treat hazardous substance effects and infectious diseases.

7.7

7.6

7.6

Environmental and occupational health: The ability to maintain the security and safety of water and food supplies, to test for hazards and contaminants in the environment, and to protect workers and emergency responders.

6.6

6.3

5.8

Source: 2018 National Health Security Preparedness Index

Despite improvements in two-thirds of states, significant inequities in health security exist across the nation. The highest state (Maryland, 8.0) scores 25 percent higher than the lowest states (Alaska and Nevada, 6.4). Generally, states in the Deep South and Mountain West regions have lower health security levels than Northeast and Pacific Coast states. Many of the lower-scoring states face elevated risks of disasters and contain disproportionate numbers of low-income residents.

"Five years of continuous gains in health security nationally is remarkable progress," said Glen Mays, PhD, MPH, who leads a team of researchers at the University of Kentucky in developing the Index. "But achieving equal protection across the U.S. population remains a critical unmet priority."

Originally developed by the Centers for Disease Control and Prevention as a tool to drive dialogue to improve health security and preparedness, the Index is a collaborative effort funded by RWJF involving more than 30 organizations. State health officials, emergency management experts, business leaders, nonprofits, researchers, and others help shape the Index.